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1 �l �• ��Perms+ No. __�--•----------�-- APPLICATION FOR SANITATION PERMIT I (Complete in Duplicate) Date issued __/J---�--- This Permit Exires 1 Year From Date Issued Application is hereby made to the San Joaquin LocalOrdealW DiNoc for or a permit to construct and install the work herein described.This application is made in compliance with County Stockton-------------------- •------------------------- JOB ADDRESS AND LOCATION.'; ? Mar--pos-----Road?---•------------------------ -- Phone Owner's Name----------F�=-�---�1oti�r__.-----�---C�cawf-�---Crane--Service----------------- ------ -- Address s��C�_4_.. ------ -- •------ -- •----�------•--. Phone._ HQ ---2... f 0�-------•- Contractor's Name--_--'_The._-D-Aja__.&._NIGHT_._SeT�tiC--T-ank--��'v�C�------- Motel Other [jInstallation .will serve: Residence ® Apartment House [3 Commercial E] Trailer Court [__1M ❑ Acres- ------------------------- ------ Number Number of baths _1---- Lot size ---- - ---------- i Number of living units: --- I- Number of bedrooms . f. Water Supply: Public system ❑ Community system ❑ Private QW Depth tCla Wafer Loamable - Q Y f❑ Adobe [ Hardpan ❑ Character of soil to a depth of 3 feet: Sand ❑ Gravel ❑ . Sandy Loam ❑ Y ❑ Previous Application Made: Yes F1No ❑ New Construction: Yes F-1No ❑Y FHA/VA: Yes ❑ No ❑ TYPE OF INSTALLATION AND SPECIFICATIONS: (No septic tank. or -cesspool permitted if public sewer is available within 200 feet.) Material________________________ y„{. - - ---------------------- Septic Tank: Distance from nearest well ----- ------- Distance from foundation ____- . Capacity E®isting No. of compartmenfis-------------------- _Size__.-------------Liquidp Disposal Field: Distance from nearest well. 50 -t --`---Distance th of each line _ationn.- �-�------- Distance tof#trenchest 121 tee_. -------•- E ]sting Number of lines_ -_.--1__.____-___ 9 Rk_ Depth of filter material--_ 1-8 - 4ength___._.__-.,-�-- & Add Type of filter material._.-•- - P t t 0 ------.__..Distance to nearest 40# line._.___r?�-____ Seepage Pit: Distance to nearest well 0--- ----Distance from faundation___� +r Depth____.. z. - {_---------- - ------ Linin material_:_RoCk-------Size: Diameter--______� ----- - i 9 Number of pits-- ---------------- Distance from nearest well ----------------Distance from foundation.--.-.-._...-- Lining material___.____..___.__.___ ---------------- Cesspool: n _-_----Li Liquid Capacity ----------------------------gals. ' ------- Depth------------------------------ q P Y ❑ Size: Diameter --------- ------ ------ -- Distance from nearest building ------------------------------------------ Privy: Distance from nearest well----------------.---- ._ an __._ Distance to nearest lot ine--------------------- - - --------------------------------- ------------------------ -- ------------- Remodeling and/or repairing (describe) --MIFF FM -------�X---D---- GF___ __----------------------------------- ------------ ------------------ ---------------------------------------- _---------------- -' - 1 ------------------------------ - one I hereby certify.that I have 'Prepared uthis application lli the San Joaat' hL cai Health �s+ricin accordance with San Joaquin County ordinances, State laws; and rules 9 Contractor] (Signed} --Thi 5 ice-.. -- - -- ------------ (Sign -- ------ -------------------------- - -- - ----- ----------- -- (Title}----------------- -------------- -...........--- BY (Plot plan, showing size of lot, location of system in relation to well ; ui i gs, etc can be pace on reverse side). FOR DEPART „ENT USE ONLY ----- -�. f ;------------------------------------ DATE APPLICATION ACCEPTED BY ----------------------------- Y,-1-6,19 ----------------- REVIEWED$Y------------------------•--------------- - -- ----------------- ----- --------- --- ------------ ------------------------------- DATE ----------------------------------------------------- REVIEWED ----•----------- ---------- ---- BUILDING PERMIT ISSUED ------------------- i ------------------------ ----------------- ----------------- Alterations and/or recommendations----------- ------ --------------------- -------- ------------------- ----- s---- - -- ----- ---------•------ - ------ ----------------------------------- -------- �t ------------ Date----- ---�-- --- (0------------------------ --------------------------- FINAL INSPECTIONBY: ------------- ----------- ------- - - ---- 13o South American Street Stockton, California SAN JOAQUIN LOCAL HEALTH DISTRICT 300 West Oak Street 132 Sycamore Street Lodi, California Manteca, California 814 North "C" Street Tracy, California ES -9-2M Revised 8-'59 F.P.Co.